Partnering with patients to improve peritonitis rates.

The London Health Sciences Centre (LHSC) peritoneal dialysis (PD) service is an active PD unit caring for approximately 100 patients. The service strives for optimal patient outcomes and, in doing so, regularly analyzes infection rates. In 2003, the LHSC peritonitis infection rate was one episode in 56 patient months (1:56). Peritonitis rates remained acceptable in 2004 (1:41) and 2005 (1:57). In 2006, the PD team became concerned when the peritonitis rate demonstrated a significant deterioration to 1:31, with a further decline to 1:27 in 2007. Because the latter rate is below the accepted Canadian benchmark of 1:30, the PD team needed to respond to the downward trend. The principles of E. Wagner's chronic disease care model and P. McGowan's patient-provider partnerships theory were used to guide the development of an intervention plan. A significant improvement in the peritonitis rate was demonstrated in 2008 and acceptable rates have been maintained for 2009.